Healthcare Provider Details

I. General information

NPI: 1821446071
Provider Name (Legal Business Name): JULIE RENEE LORTZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2016
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 PAESANOS PKWY STE 101
SAN ANTONIO TX
78231-1225
US

IV. Provider business mailing address

3503 PAESANOS PKWY STE 101
SAN ANTONIO TX
78231-1225
US

V. Phone/Fax

Practice location:
  • Phone: 210-492-8922
  • Fax: 210-479-2010
Mailing address:
  • Phone: 210-492-8922
  • Fax: 210-479-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number30186
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR9077
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberR9077
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: